Westminster Hospital and Medical School (Hansard, 25 January 1984)

§ Lord Segal
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Home Office (Lord Glenarthur)
My Lords, the Government welcome the decision of the University of London that the Westminster Hospital Medical School and the Charing Cross Hospital Medical School should be amalgamated. I understand that legislation is being prepared to create the new school later this year. As to the Westminster Hospital, we do not foresee any major change in its role in the immediate future.

§ Lord Segal
My Lords, while I thank the noble Lord for that reply, I would like to ask him this question. Since the removal of St. George's Hospital and Charing Cross Hospital to the suburbs, is the number of beds available in the west of London able to cope with major emergencies such as the recent Harrods bomb disaster, and does not this emphasise the importance of retaining Westminster Hospital and all its departments as the utmost degree of efficiency?
As regards the second part of my question, arising out of this, would it not be better if every effort were made to allow the Westminster Medical School to retain its independent identity?

§ Lord Glenarthur
My Lords, I hope that I have made clear in my original Answer, so far as the last part of the noble Lord's supplementary question is concerned, that it has been agreed, and the Government have welcomed the decision, to amalgamate the Charing Cross Hospital Medical School with the Westminster Hospital Medical School.
So far as concerns the noble Lord's first supplementary question about the importance of Westminster in relation to the Harrods bombing, which I think is the point he makes, yes, my Lords, I am aware of the important role Westminster played in this. I should certainly like to add my voice to the many who have not only condemned the mindless atrocity of that act but also praised the excellent treatment provided to the casualties by the hospitals in the area, including the Westminster Hospital. But, my Lords, there is no present intention, no formal proposal, to close Westminster Hospital. Should such proposals be made, then, of course, every consideration will be given to them on their merits, and they will only be allowed to go ahead if we are convinced that to do so would be to the benefit of patient services within the National Health Service.

§ Lord Molloy
My Lords, can the Minister give the House an assurance that when the amalgamation takes place there will be no diminution of staff, either from Charing Cross or Westminster, or diminution of pupils when the medical schools are joined together? Can the noble Lord further state quite clearly that the apprehensions which are now extant in Westminster Hospital about the future are unfounded? Will he take advantage of this opportunity to remove those apprehensions completely and say that Westminster Hospital is quite safe from any future Government intervention to destroy it?

§ Lord Glenarthur
My Lords, documents have been issued by the Victoria Health Authority, but these have been of an informative nature, setting out the context in which strategic proposals need to be developed. The most recent of these, which was issued in June last year, mentioned that a variety of options had been the subject of public speculation, including closure of one or more hospitals in the district; the document made it clear that further consideration and discussion would be needed before proposals were issued for public consultation.

Lord Paget of Northampton
My Lords, does the noble Lord's rather lengthy reply mean yes, and, if it does, would he tell us so?

§ Lord Glenarthur
My Lords, if the noble Lord reads the answer in Hansard, he will discover that I did not say either yes or no.

§ Lord Ennals
My Lords, would it not be helpful if the noble Lord would pass the encouraging answer he first gave to the Victoria Health District? Is he aware, bearing in mind that they have suffered a cash cut of £1.8 million in 1984–85 and expect a further cash cut of £1.8 million in 1985–86, that the health district have informed me today that the options they were considering included the total closure of the Westminster Hospital? Another was a substantial reduction in beds, including the closing of the accident and emergency unit to which tribute has already been paid for the role that it played at the time of the tragic Harrods bombing just before Christmas. If the noble Lord is telling the House that the Westminster Hospital is safe, can he accept that, because so many noble Lords owe their lives to the skills of the doctors and nurses in that hospital, there will be a cheer from all sides of the House? But will he also tell the health district, which is responsible, that that is the situation that the Minister has decided upon?

§ Lord Glenarthur
My Lords, my right honourable friend the Secretary of State and my right honourable friend the Minister for Health are, of course, in touch with the Victoria Health Authority on these proposals. I do not think that the noble Lord's claim that it is not aware of what is going on is the case at all. For the longer term, my right honourable friend the Secretary of State awaits the strategic proposals now being developed by the Victoria Health Authority for the future of health services for which that authority is responsible, and also the strategic plan being prepared by the North West Thames Regional Health Authority.
We remain committed to the policy of securing a fairer distribution of National Health Service resources across the country. This refers to the second part of the noble Lord's supplementary question. Significant inequalities still remain which will be greatly reduced over the next 10 years or so by differential allocations of growth money and some reductions in revenue for the most over-provided regions, such as the North West Thames. Within North West Thames, Victoria is the district with the highest level of NHS resources per head of population served, and must therefore plan on the assumption that its revenue allocations will be reduced.

§ Lord Ennals
My Lords, in the light of what the noble Lord has said, the assurance he gave in the answer to my noble friend Lord Segal, that no changes were proposed in the role of the Westminster Hospital seems now to have been changed. Can he say whether his last answer or the original answer that he gave was correct?

§ Lord Glenarthur
My Lords, I was asked if there were any firm plans to close Westminster Hospital and the answer that I gave was that there are no firm plans to close it, but there are proposals that are being considered which may or may not include closure. No decision has been taken. I hope the noble Lord will accept that.

§ Lord Todd
My Lords, would the noble Lord the Minister perhaps agree that had the University of London accepted the proposals in the report of the Royal Commission on Medical Education in 1968 the Question we are discussing today would have been quite unnecessary?

§ Lord Glenarthur
My Lords, I must confess that I am not familiar off the top of my head with the proposals which the noble Lord mentions. I will, of course, look at them, and if I can answer that question in writing I shall do so.

§ Lord Annan
My Lords, the noble Lord wisely said, in the response to the first part of the supplementary question of the noble Lord, Lord Segal, that his answer was neither yes nor no. I very much hope that the noble Lord's answer to the second part of the supplementary question is a firm no, because the noble Lord will remember that the noble Lord, Lord Segal, asked whether we could go back to square one and have an entirely independent Westminster Medical School and that the merger between the Charing Cross Medical School and the Westminster Medical School should not take place. Is the noble Lord aware that the University of London—no doubt rather late off the mark as the noble Lord, Lord Todd, observed—has nevertheless been trying to reduce the number of medical schools in order to reduce costs? Is he further aware that this merger is the first major success which has been achieved in this programme? Does he agree that there is considerable scope for further mergers of this kind? Does he also agree that the capacity of beds as regards the needs of the medical schools in certain subjects, such as obstetrics, is sometimes twice the capacity needed?

§ Lord Glenarthur
My Lords, I am grateful to the noble Lord for his comments about the amalgamation. He asked one or two other questions and I may not be able to follow up all of them without reading what he said. As regards the implication that the University Grants Committee was responsible for the so-called rationalisation of the London medical schools, the answer is, "No, not at all". The proposals to combine some of the London medical schools into larger and more viable units were discussed by the University of London long before the reductions in funding referred to. I note that, despite the reduced level of funding, the London medical schools were able to expand their intake by nearly 7 per cent. between 1980 and 1982.

§ Lord Molloy
My Lords, will the Minister simply do nothing more than acknowledge that the staff of the Westminister Hospital are perturbed when they hear statements from the Victoria Health Authority and ministerial statements which cause distress because the staff do not know which to believe? Will the Minister at least say that as soon as humanly possible he will make a statement which will clear up all the doubts and let the staff of this famous hospital, who have contributed so much, know where they stand?

§ Lord Glenarthur
My Lords, as I hope I explained earlier, no firm decisions have been reached and, therefore, rumours will circulate, as they always do, 241 until a decision is made. But no decision has been made and, when it is, and if it is thought proper to announce it here, I dare say I shall have an opportunity to do so.

§ Lord Segal
My Lords, is it not of the utmost importance, where human life is at stake, that a patient should be admitted to the nearest hospital, whether it is public or private?

§ Lord Glenarthur
Yes, my Lords, but, as I said, there is sometimes also the problem of rationalising services within the National Health Service generally.